FINAL RESULTS OF A PHASE-II CHEMORADIATION PROTOCOL FOR LOCALLY ADVANCED CERVICAL-CANCER - RTOG-85-15

Background: The lack of improved cure rates for advanced cervical canc er after three decades of megavoltage radiotherapy (RT) has prompted c ontinued efforts in improved treatment delivery. Concurrent chemoradia tion (CR) is one of the several avenues being explored to improve thes e results. Methods: Sixty women with advanced cervical cancer (30 pati ents with unfavorable Stage IIB and 30 patients with Stages III and IV A) were treated with CR comprising of a combination of external and in tracavitary RT delivering between 7000 to 7500 cGy total to point A an d 5890 to 6015 cGy to point B along with one cycle of 5-FU and mitomyc in C and a second cycle of 5-FU and cis-platinum. Results: Grade 3 and 4 RT-related toxicities were 15 and 3%, respectively. Chemotherapy-re lated Grade 3 and 4 toxicities were 9 and 2%, respectively, The 5-year survival for unfavorable Stage IIB patients was 48%; for Stages III a nd IVA it was 39%. Conclusions: The toxicity of this particular CR reg imen was acceptable and suggests that further qualitative and quantita tive intensification of chemoradiation may be attempted, Retrospective comparisons with PCS studies and previous RTOG studies 79-20 and 80-0 5 suggest that this particular chemoradiation regimen may offer a mode st survival advantage over RT alone for Stages III and IVA disease. A CR regimen with higher doses of radiotherapy and a greater number of a ctive chemotherapeutic agents may yet result in acceptable toxicity an d further improve cure rates in advanced and poor prognostic featured cervical cancer. (C) 1996 Academic Press, Inc.